HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 14-16
Emergency: Foreign Body Airway Obstruction (Heimlich Maneuver) __RN __HHA
3. Form a fist and place the thumbside of your fist on
the middle of breastbone (avoid the xiphoid process
or margins of the rib cage).
4. Grasp your fist with your other hands and exert five
(5) quick backward thrusts. Continue the series of
chest thrusts until the obstruction is relieved.
Obese or Pregnant Victim - Lying (Known Choking)
1. Kneel facing the victim.
2. Position victim on his/her back, place the heel of
your hand on the lower half of the victim's sternum
(avoiding the xiphoid process or margins of the
cage).
3. Administer quick downward thrusts that will
compress the chest cavity 1-1/2 to 2 inches.
Continue the series of chest thrusts until the
obstruction is relieved.
Choking Victim Who Becomes Unconscious
Victim with obstructed airway becomes unconscious:
1. Additional Assessment
a. Position the victim. Turn on back as a unit;
place face up with arms by sides.
b. Call for "Help" and call 911 if no one else
available to call.
2. Foreign Body Check - Finger Sweep:
a. Keep victim's face up.
b. Use tongue-jaw lift to open mouth.
c. Sweep deeply into mouth to remove foreign
body.
3. Breathing Attempt:
a. Open airway with head tilt/chin lift.
b. Seal mouth and nose properly.
c. Attempt to ventilate.
4. Heimlich Maneuver - Abdominal Thrusts:
a. Straddle victim's thighs.
b. Place heel of one hand against victim's
abdomen, in the midline slightly above the navel
and well below the top of the xiphoid.
c. Place second hand directly on top of first hand.
d. Press into the abdomen with quick upward
thrusts.
e. Perform 5 abdominal thrusts.
5. Sequencing. Repeat steps 2-4 until airway
obstruction is removed.
6. After airway obstruction is removed: Check for
breathing and pulse. If pulse is absent, ventilate a
second time, and start cycles of compressions and
ventilations. If pulse is present, open airway and
check for spontaneous breathing. If breathing is
present, monitor breathing and pulse closely;
maintain open airway. If breathing absent, perform
rescue breathing at 12-times/minute and monitor
pulse.
7. Place in recovery position (also called fetal
position.)
Unconscious Victim and Cause Is Not Known
1. Call 911. Open airway by hyperextending the neck
and establish absence of breathing; attempt to
ventilate.
2. If unsuccessful, reposition head and try to ventilate
again.
3. If still unable to open airway, administer five
abdominal thrusts.
4. Perform tongue-jaw lift and finger sweep.
5. Reposition head and attempt to ventilate.
6. If victim cannot be ventilated, repeat sequence of
abdominal thrusts, finger sweep; attempt to ventilate
until successful. If successful in removing the
foreign object, perform mouth-to-mouth ventilation
or CPR if necessary (see policy____).
AFTER CARE:
1. Document in patient's record:
a. Incident.
b. Treatment provided.
c. Patient's response to treatment.
2. Notify physician. Document any subsequent orders,
if indicated.
3. Inform nursing supervisor of occurance.
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